Utilization Review Manager - Home Care ensures quality and level of care for patients are up to established standards and comply with federal, state, and local regulations. Investigates and resolves reports of inappropriate care. Being a Utilization Review Manager - Home Care may require a bachelor's degree. Typically reports to a head of a unit/department. To be a Utilization Review Manager - Home Care typically requires 4 to 7 years of related experience. Contributes to moderately complex aspects of a project. Work is generally independent and collaborative in nature. (Copyright 2024 Salary.com)
Hiring a RN UR Case manager for a full remote opportunity with hospital!! MUST HAVE Current CA RN Licensure, InterQual experience, EPIC Experience and at least 2 years of experience! Amazing team!
M-F day shift with being open to rotating weekends.
Description:
This position facilitates utilization management (UM) processes to support that the right care is provided at the right place and at the right time. To accomplish these goals, he/she applies established criteria to evaluate the appropriateness of admission, level of care, continued hospitalization, and readiness for care transition; assures timely movement of patients throughout the continuum of care by conducting concurrent review and proactively resolving care, service, or transition of care delays/issues as necessary; in collaboration with the Facility Acute Care Manager (CM). This position provides third-party payers clinical information to assure reimbursement; and coordinating care with the treatment team, patient, family and others as necessary.
Additional Skills & Qualifications:
• Current CA RN Licensure
• InterQual experience
• EPIC Experience
• 2 years of experience
• Recent acute hospital case management experience preferred
Experience Level:
Intermediate Level
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0 Utilization Review Manager - Home Care jobs found in Mesa, AZ area